经曰∶诸病喘逆，转筋反戾，小便混浊，痈疽疡疹，瘤气结核，吐下霍乱，瞀郁肿胀，鼻塞
衄，
血溢血泄，淋闭，身热恶寒，战栗，惊惑悲笑，谵妄，衄 血汗，皆属于热。热毒蕴积，非朝夕之
故。人生阴平阳秘，神气以宁，无热可积。徇情纵欲，因致积热，皆出于心，甚则伤血。或在心肺
之内，令人口苦咽干，涎唾稠粘，目涩多眵。盖心气通于舌，脾气通于口。故口舌生疮，便秘等证
，皆积热所致也。经曰∶ ，粗大者，阴不足，阳有余，为热中也。治宜清热降火，养血滋阴。
主方 黄连 连翘 黄芩 栀子 薄荷 大黄 甘草 芒硝（各七分）加灯心，水煎服。
咳嗽痰多，胸膈胀满，大便利，加桑皮、杏仁、枳壳、桔梗，去芒硝、大黄。
清炎解毒汤 长幼内热痰盛，腮肿项核，口舌破烂生疮。
牛蒡子（三钱） 甘草（钱半） 犀角 防风 荆芥（各一钱）水煎服。
既济清神散 益肾水，降心火，清上实下。
桔梗 黄芩 川芎 山栀 当归 羌活 白术 茯苓（各八分） 知母 甘草 薄荷（各五分）
煎，入蜜二匙。
神芎丸 一切热证。常服清头目，利咽膈，清痰利气，神强体健。
滑石 黑丑（各四两） 大黄 黄芩（各二两） 黄连 薄荷 川芎（各五钱）
上末，水叠丸桐子大，每四十丸，常服二十丸，温水下。
碧雪 一切积热，喉闭口疮，发热烦闷，蜜丸频噙。（喉闭，芦管吹入，方见舌证。）
简便方 热烦不食， 草捣汁服。或蓝靛水调下。
热毒∶鸡子清（三个），蜜（一杯），和服。或软石膏（ 研），每服一钱，水下。
热渴∶葛粉（四两），粟米（半升，水浸一宿）拌煮粥食。悉尼、西瓜、甘蔗可食。
热攻心∶牛蒡子根捣汁饮。诸热，用六月雪煎汤，日三服。
〔补遗〕藿香正气散 伤寒头痛发热，咳嗽痰饮，霍乱呕逆，中脘疼。
藿香 紫苏 桔梗（各一钱） 白术 浓朴（各八分） 前胡 陈皮 半夏 茯苓 甘草（各
六分） 腹皮 白芷（各五分）
上剂加生姜三片，黑枣一枚，水煎热服。盖取微汗，渣再煎。
〔补遗〕桂苓甘露饮 清暑除热，利小便，止烦渴，霍乱吐泻。
泽泻（一钱五分） 猪苓 茯苓 白术（各一钱） 肉桂（五分） 滑石 寒水石 石膏（各
钱二分） 甘草（四分） 水煎，研末服亦可。霍乱，姜汤下。
发背方 败龟板（去肋，黄蜡炙透，）研末服。外五倍子末（二两，）藤黄（三钱，）醋化调敷。
疔疮方 露天铁锈研极细，金银簪甲挑破掺，原皮盖，根出安。
下疳方 小蓟（即小贝母） 土枸杞（根皮。各五两） 煎浓汁频浸，三日痛止，愈。
肺痈方 鱼腥草煮汁，不住饮，即痊。或金丝荷叶、白酒，捣汁饮。
便毒方 棉地榆（四两） 山甲（二片，炒，研） 白酒三碗煎。加甘草、银花、白芷、
皂刺水煎，早服妙。
梅疮 棉花子（仁，捣如泥） 槐花（细末，研匀）丸服。
对口 金银花 槿树根皮（各一两）水、酒煎，饱服。
The *Classic of Difficult Issues* (Jing) states: Various diseases presenting with panting and upward rebellion, muscle spasms and convulsions, opisthotonos, turbid urine, carbuncles, sores, ulcers, and rashes, goiters, qi masses, and phlegm nodules, vomiting and diarrhea with cholera-like symptoms, mental confusion, depression, swelling, nasal congestion, epistaxis, hematemesis or hematochezia, stranguria and urinary retention, fever with aversion to cold, shivering, fright, bewilderment, sadness, inappropriate laughter, delirium, manic behavior, nosebleeds, and sweating blood—all these belong to Heat. Heat toxin accumulating and stagnating is not a matter of one day or night. When a person's Yin is peaceful and Yang is secure, their Shen Qi (Spirit and Vital Energy) remains tranquil, and there is no accumulation of Heat. However, indulging in emotions and desires leads to accumulated Heat, which originates from the Heart; in severe cases, it damages Blood. If this Heat resides within the Heart and Lungs, it causes bitter taste in the mouth, dry throat, thick and sticky saliva, dry eyes, and excessive eye discharge. Since Heart Qi connects to the tongue and Spleen Qi connects to the mouth, conditions such as mouth and tongue ulcers and constipation are caused by accumulated Heat. The *Classic* also states: A coarse and large pulse indicates insufficient Yin and excess Yang, constituting Middle Heat. Treatment should focus on clearing Heat, descending Fire, nourishing Blood, and yin-nourishing. The primary formula consists of Huanglian (Coptidis Rhizoma), Lianqiao (Forsythiae Fructus), Huangqin (Scutellariae Radix), Zhizi (Gardeniae Fructus), Bohe (Menthae Haplocalycis Herba), Dahuang (Rhei Radix et Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma), and Mangxiao (Natrii Sulfas)—each 0.7 fen—added with Dengxincao (Junci Medullae), decocted in water and taken orally.
If accompanied by cough with profuse sputum and chest/epigastric fullness, but with free bowel movements, add Sangbaipi (Mori Cortex), Xingren (Armeniacae Semen Amarum), Zhike (Aurantii Fructus Immaturus), and Jiegeng (Platycodonis Radix); remove Mangxiao and Dahuang.
Qingyan Jiedu Tang (Clear Inflammation and Detoxify Decoction): Suitable for children and adults with internal heat and abundant phlegm, presenting with swollen cheeks, cervical lymphadenopathy, and oral/tongue ulcers.
Formula: Niubangzi (Arctii Fructus) 3 qian, Gancao (Glycyrrhizae Radix et Rhizoma) 1.5 qian, Xijiao (Rhinocerotis Cornu), Fangfeng (Saposhnikoviae Radix), Jingjie (Schizonepetae Herba)—each 1 qian. Decoct in water and take orally.
Jiji Qingshen San (Ji Ji Clear Spirit Powder): Benefits Kidney Water, descends Heart Fire, clears upper jiao heat, and consolidates lower jiao.
Formula: Jiegeng (Platycodonis Radix), Huangqin (Scutellariae Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Shanzhi (Gardeniae Fructus), Danggui (Angelicae Sinensis Radix), Qianghuo (Notopterygii Rhizoma et Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Fuling (Poria)—each 0.8 fen; Zhimu (Anemarrhenae Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma), Bohe (Menthae Haplocalycis Herba)—each 0.5 fen. Decoct and add two spoons of honey.
Shenxiong Wan (Shenxiong Pill): Indicated for all heat syndromes. Regular consumption clears the head and eyes, benefits the throat and diaphragm, clears phlegm, regulates qi, strengthens spirit, and promotes physical health.
Formula: Huashi (Talcum), Heiqiu (Pharbitidis Semen Nigrum)—each 4 liang; Dahuang (Rhei Radix et Rhizoma), Huangqin (Scutellariae Radix)—each 2 liang; Huanglian (Coptidis Rhizoma), Bohe (Menthae Haplocalycis Herba), Chuanxiong (Ligustici Chuanxiong Rhizoma)—each 5 qian.
Preparation: Grind into fine powder, make pills with water resembling tung tree seeds. Take 20 pills regularly per dose, washed down with warm water.
Bixue (Green Snow): Indicated for all accumulated heat, throat closure (hou bi), oral ulcers, fever, and restlessness. Make into honey pills and frequently hold in the mouth. (For throat closure, blow powder into the throat using a reed tube; see Tongue Syndromes chapter.)
Simple Prescription: For heat-induced烦躁 (restlessness) and loss of appetite. Crush [missing character, likely a herb] and take the juice. Alternatively, mix with indigo water.
Heat Toxin: Mix three egg whites with one cup of honey and take. Or use Ruguoshi (Gypsum Fibrosum, soft variety), finely ground, taking 1 qian per dose with water.
Heat Thirst: Use Gewen (Puerariae Radix) 4 liang and millet (half sheng, soaked overnight in water). Mix and cook into porridge. Sydney fruit (likely referring to a specific tropical fruit or local term), watermelon, and sugarcane are edible.
Heat Attacking the Heart: Drink juice extracted from crushed Niubangzi root. For all heat conditions, decoct Liuyuexue (Hexasepalum Tea Flower) and take three times daily.
[Supplement] Huoxiang Zhengqi San (Agastache Regulating Qi Powder): Indicated for headache and fever due to Cold Damage (Shanghan), cough with phlegm-fluids, cholera with vomiting and rebellious qi, and epigastric pain.
Formula: Huoxiang (Agastaches Herba), Zisu (Perillae Folium), Jiegeng (Platycodonis Radix)—each 1 qian; Baizhu (Atractylodis Macrocephalae Rhizoma), Houpo (Magnoliae Officinalis Cortex)—each 0.8 fen; Qianhu (Peucedani Radix), Chenpi (Citri Reticulatae Pericarpium), Banxia (Pinelliae Rhizoma), Fuling (Poria), Gancao (Glycyrrhizae Radix et Rhizoma)—each 0.6 fen; Fupi (Tangerine Peel variant/Betel Nut Husk?), Baizhi (Angelicae Dahuricae Radix)—each 0.5 fen.
Usage: Add three slices of fresh ginger and one black date to the above ingredients. Decoct in water and take hot. The goal is to induce slight sweating; the dregs may be decocted again.
[Supplement] Guiling Ganlu Yin (Cinnamon, Polyporus, and Dew Drink): Clears summerheat, removes heat, promotes urination, relieves thirst, and treats cholera with vomiting and diarrhea.
Formula: Zexie (Alismatis Rhizoma) 1.5 qian; Zhuling (Polyporus), Fuling (Poria), Baizhu (Atractylodis Macrocephalae Rhizoma)—each 1 qian; Rougui (Cinnamomi Cortex) 0.5 fen; Huashi (Talcum), Hanshuishi (Calcitum), Shigao (Gypsum Fibrosum)—each 1.2 qian; Gancao (Glycyrrhizae Radix et Rhizoma) 0.4 fen.
Usage: Decoct in water and take. Can also be taken as a powder. For cholera, wash down with ginger soup.
Fabei Formula (Back Carbuncle Formula): Use Baiguiban (Testudinis Carapax et Plastrum, removed ribs, roasted through with yellow beeswax), ground into powder and taken orally. Externally, apply a mixture of Wubeizi (Myrobalani Fructus) powder (2 liang) and Tenghuang (Gambogi Resin) (3 qian) dissolved in vinegar.
Dingchuang Formula (Carbuncle/Furuncle Formula): Grind exposed iron rust to an extremely fine powder. Pierce the lesion with a silver hairpin tip, apply the powder, cover with original skin, and allow the root/pus to discharge for healing.
Xiagan Formula (Chancre/Gonorrhea Ulcer Formula): Xiaoji (Cirsii Herba, also known as Xiaobeimu), Tu Gouqi (Lycii Cortex/Radix Bark)—each 5 liang. Decoct into a concentrated liquid and frequently soak/wash the area. Pain stops in three days, leading to cure.
Fei Yong Formula (Lung Abscess Formula): Boil Yuxingcao (Houttuyniae Herba) to extract juice and drink continuously until cured. Alternatively, crush Jin Si Heye (Nelumbinis Nelumbo Leaf) with white wine, extract juice, and drink.
Biandu Formula (Inguinal Swelling/Syphilitic Gumma Formula): Mian Diyü (Sanguisorbae Radix) 4 liang, Shan Jia (Manis Squama, stir-fried and ground) 2 slices. Decoct with three bowls of white wine. Add Gancao (Glycyrrhizae Radix et Rhizoma), Yinhua (Lonicerae Japonicae Flos), Baizhi (Angelicae Dahuricae Radix), and Zaoci (Gleditsiae Spina) and decoct in water. Taking in the morning is excellent.
Meichuang (Syphilis): Cottonseed kernel (crushed into paste), Huaihua (Sophorae Flos, fine powder mixed evenly). Form into pills and take.
Duikou (Opposite Mouth/Back Midline Carbuncle): Jinyinhua (Lonicerae Japonicae Flos), Jinshugenpi (Hibisci Mutabilis Cortex)—each 1 liang. Decoct in water and wine. Take after a full meal.